The ads are all over the TV and magazines— if you have heartburn, you should be taking one of the acid-reducing medications that are out there, preferably for the rest of your life. It’s DANGEROUS to have acid reflux (true) and is vital to stop it before it does permanent damage (also true), but turning off the acid in your stomach, whether it’s with a purple pill or popping an antacid, or even taking acid-suppressing Chinese herbs will lead to a myriad of other problems and is NOT addressing the root of the problem. As functional medicine practitioners, our office is about restoring function to the body, and yet many practitioners simply try to neutralize the acid, which is only a symptom of the root problem.
Many, many people suffer from a myriad of digestive problems. And yet, most of them are suffering NOT from too much stomach acid, but from not enough. Not enough? How can that be?
The function of your stomach acid is to digest protein. When someone has their stomach acid “turned off”, they can’t digest well. (I’ll talk about what turns off stomach acid in a moment). What this looks like is that when someone eats, say, a piece of chicken, (soy is difficult to digest in any form that’s not fermented, so it can’t be used as an example), it lands in the stomach, and needs hydrochloric acid to break it down. When there isn’t enough hydrochloric acid, the protein sits in the stomach, and starts to putrefy, creating acid and gases. NOW the person might have some symptoms — a sour stomach, belching, or even an acid reflux. But this all happens because they initially didn’t have enough acid to digest properly.
If you have good amounts of stomach acid, it closes the upper sphincter of the stomach when you eat to prevent that good acid from going up into the esophagus. And it also opens the lower sphincter to empty your stomach after the food has been digested. But if you don’t have enough acid, not only can you not digest the protein, but the upper sphincter doesn’t close tightly enough, causing acid reflux and potential damage to the esophagus. And low stomach acid causes the lower stomach sphincter to stay closed, which leads to this odd symptom of getting too full too quickly, because the stomach doesn’t empty properly.
And you need good acidity to absorb minerals like calcium, iron, magnesium, copper, zinc, as well as B12… there are schools of thought that think that not-low-enough stomach pH is the root of many health problems, and considering that magnesium, for example, is used in literally HUNDREDS of enzyme reactions, this is probably not far from the truth. People with poor stomach acid also cannot absorb Vitamins C, K, and the B complex vitamins. Think of all the people taking calcium, for example — the majority of them are unable to absorb it, especially because stomach acid production declines as you age.
Did you know that the pH of your stomach, when it’s healthy, is between 1 and 2? There’s a reason it’s that low — your stomach is at the start of a line of defense of your immune system. You know all those people with sinus infections and post-nasal drip? That infected material drips down into the stomach, where, if the person has good acidity, it kills off any bacteria. Or what about bacteria in foods? Or possibly parasites? Again, good acidity can help kill off anything that might cause food poisoning or infestations of any kind.
And then there are the bacteria of your gut — it’s not a mistake that they’re called “acidophilus”. Those bacteria want to live in an acidic environment. When our gut is not acidic enough, it is nearly a waste to take the probiotics that so many people are ingesting because they don’t have the acidic environment required to survive. And not having an acidic-enough environment allows detrimental bacteria like Candida to survive and flourish. Cutting out sugars, and yeast, etc. is not enough to treat Candida — the digestive track has to become acidic enough to kill off the detrimental bacteria as well as provide an environment for the correct flora.
Have you ever wondered why some people have gas with smell? That particular problem is almost always from an inability to digest protein, the primary function of the stomach acid. If someone doesn’t have good stomach acid and they eat protein, the protein doesn’t digest well in the stomach, and then ferments all the way down the digest track, causing foul-smelling gas as the end result. (Gas without smell is a difficulty digesting sugars and carbs, and many people see a sharp decline in that when they reduce them).
The entire digestive track is orchestrated by good stomach acid. If there isn’t enough, the gall bladder doesn’t get triggered properly to function, and the pancreatic enzymes aren’t released for digestion. So, knowing the vital functions of stomach acid, and it seems absolutely insane to take ant-acids, or proton-pump inhibitors, doesn’t it?
How does the stomach acid get turned off? And what can be done about it? The main reasons that stomach acid gets turned off is from stress — stress from high carb intake (high sugar levels are enormously stressful for the body), mental stress, physical stresses like excessive exercise, or physical stresses like inflammation, infections, anemia, or food intolerances. People who have had bariatric surgeries will often have the acid-producing part of their stomach removed or bypassed. We’d estimate that a minimum of 90% of the people we see in clinic have reduced stomach acid. So what kind of symptoms do they have?
They’re people with blood sugar issues (that’s nearly everyone), that have gas (especially gas with smell), bloating, “fullness”, or have acidity or sour stomach, or acid reflux. People with constipation. Or people with a loss of appetite for meat – that is a classic sign of low stomach acid, or people who don’t eat meat because it “doesn’t digest well”. Older people lose some of their ability to produce stomach acid, often just when they need it most — to digest protein to keep muscle mass, and for vitamins and minerals.
Now, most people simply need supplementation of digestible hydrochloric acid, known as betaine hydrochloride, for 3-6 months to restore proper acidity to the stomach and eliminate the symptoms they’re having. After that, they may simply need to take it when in periods of stress, or travel, or when having a large meal, or when symptoms like gas start up again.
Apple cider vinegar is a popular home remedy for low stomach acid, but it’s quite weak. It will help a little, but you might consider supplementation, because if the person is continuing to stress their body in whatever ways that we do, the apple cider vinegar might not be enough, and considering how much we need good acid, it might be worthwhile to supplement.
You might also want to limit how much water is drunk at a meal. We get served these huge glasses of water and are told to drink large amounts of water during the day, but water will dilute the action of stomach acid, and reduce it’s effectiveness. Some water is OK, but it’s best to drink between meals, and, of course, avoid ice water.
Learning how to watch for these symptoms can start you solidly on the path to becoming healthier, and being certain you are absorbing all the vital nutrients you need. Feel free to talk to you practitioner or functional medicine practitioner if you have more questions.